Increased bone turnover in prepubertal, pubertal, and postpubertal patients receiving carbamazepine

Epilepsia. 2002 Dec;43(12):1488-92. doi: 10.1046/j.1528-1157.2002.13002.x.


Purpose: To study the markers of bone turnover in epilepsy patients in the different stages of the pubertal growth before and after the beginning of carbamazepine (CBZ) monotherapy.

Methods: We have investigated bone turnover in 60 epilepsy patients treated with CBZ. They were stratified according to pubertal stage and compared with a control group of 60 sex- and age-matched healthy children.

Results: After 2 years of therapy, we found higher values of the serum markers of bone formation [bone alkaline phosphatase (bone ALP), osteocalcin (OC), carboxy-terminal propeptide of type I procollagen (PICP), amino-terminal propeptide of type III procollagen (PIIINP)], and of bone resorption [carboxy-terminal telopeptide of type I collagen (ICTP) and the urinary cross-linked N-telopeptides of type I collagen (NTX)] in patients than in control subjects, in presence of a normal vitamin D metabolism.

Conclusions: CBZ induces an increase of bone formation and of bone resorption that seems to be independent of the pubertal stage.

Publication types

  • Evaluation Study
  • Comment

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / therapeutic use
  • Biomarkers / blood
  • Bone Diseases, Metabolic / chemically induced*
  • Bone Diseases, Metabolic / diagnosis
  • Bone Resorption / chemically induced
  • Bone Resorption / diagnosis
  • Carbamazepine / adverse effects*
  • Carbamazepine / therapeutic use
  • Child
  • Epilepsy / drug therapy*
  • Female
  • Humans
  • Male
  • Osteoporosis / chemically induced*
  • Osteoporosis / diagnosis
  • Puberty / physiology


  • Anticonvulsants
  • Biomarkers
  • Carbamazepine